Wounds

The long-term outcome for amputees has improved due to better understanding of the management of traumatic amputation, early emergency and critical care management, new surgical techniques, early rehabilitation, and new prosthetic designs. New limb replantation techniques have been moderately successful, but incomplete nerve regeneration remains a major limiting factor.

Often, the patient will have a better outcome from having a well-fitting, functional prosthesis than a nonfunctional replanted limb.

Causes

Traumatic amputations usually result directly from factory, farm, or power tool accidents or from motor vehicle accidents. Natural disasters, war, and terrorist attacks can also cause traumatic amputations.

Symptoms

A body part that has been completely or partially cut off

Bleeding (may be minimal or severe, depending on the location and nature of the injury)

Pain (the degree of pain is not always related to the severity of the injury or the amount of bleeding)

Bleeding control

Try to calm and reassure the person as much as possible. Amputation is painful and extremely frightening.

Control bleeding by applying direct pressure to the wound. Raise the injured area. If the bleeding continues, recheck the source of the bleeding and reapply direct pressure, with help from someone who is not tired. If the person has life-threatening bleeding, a tight bandage or tourniquet will be easier to use than direct pressure on the wound. However, using a tight bandage for a long time may do more harm than good.

Save any severed body parts and make sure theystay with the patient. Removeany dirty material that can contaminate the wound, if possible.Gently rinse the body part if the cut end is dirty.

Wrap the severed part in a clean, damp cloth, place it in a sealed plastic bag and place the bag in ice cold water.

Do NOT directly put the body part in water without using a plastic bag.

DoNOT put the severed part directly on ice. Do NOT use dry ice as this will cause frostbite and injury to the part.

If cold water is not available, keep the part away from heat as much as possible. Save it for the medical team, or take it to the hospital. Cooling the severed part will keep it useable for about 18 hours. Without cooling, it will only remain useable for about 4 to 6 hours.

Keep the patient warm.

Take steps to prevent shock. Lay the person flat, raise the feet about 12 inches, and cover the person with a coat or blanket. Do NOT place the person in this position if a head, neck, back, or leg injury is suspected or if it makes the victim uncomfortable.

Once the bleeding is under control, check the person for other signs of injury that require emergency treatment. Treat fractures, additional cuts, and other injuries appropriately.

Fractures

If more pressure is put on a bone than it can stand, it will split or break. A break of any size is called a fracture. If the broken bone punctures...

Amputation repair - illustration

In case of a complete amputation, the body part can be reattached. The body part should be wrapped in a clean, damp cloth, placed in a sealed plastic bag, and the bag immersed in cold water (ice water if available). Cooling the severed body part will keep it alive for much longer than if it is at room temperature or warmer.

Amputation repair

illustration

Amputation repair - illustration

In case of a complete amputation, the body part can be reattached. The body part should be wrapped in a clean, damp cloth, placed in a sealed plastic bag, and the bag immersed in cold water (ice water if available). Cooling the severed body part will keep it alive for much longer than if it is at room temperature or warmer.